Healthcare Provider Details

I. General information

NPI: 1831589290
Provider Name (Legal Business Name): JOSEFINA LINIS CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2015
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25919 GADING RD
HAYWARD CA
94544-2725
US

IV. Provider business mailing address

25919 GADING ROAD
HAYWARD CA
94544
US

V. Phone/Fax

Practice location:
  • Phone: 510-782-8424
  • Fax:
Mailing address:
  • Phone: 510-782-8424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1614
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number1614
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: